Otitis externa

Indications for adult urgent referral

If patients present with otalgia disproportionate with signs in diabetic patient unresponsive to topical therapy (refer immediately to ED to exclude skull base osteomyelitis).

If the patient has an ear canal occluded by oedema and unable to clear discharge (refer immediately to ED).

For urgent referrals, contact the ENT Register at the relevant hospital.

Indications for paediatric emergency referral

Systemically ill child with high fever, significant or disproportionate ear pain and unresponsive to treatment, e.g. cellulitis or ear canal occluded by oedema, mastoiditis, malignant otitis externa.

Criteria for routine specialist referral via CRS

These criteria apply to both adult and paediatric patients.

Patients must present with chronic otitis externa, of duration greater or equal to one month, causing significant morbidity and not responding to recommended treatment.

Routine referral information required

All referrals must include comprehensive medical history, relevant test results, summary of clinical findings and treatment to date.

History to note:

  • otalgia, hearing loss, otorrhoea, pruritic ear canal
  • history of ear canal trauma (e.g. cotton bud/hair pin)
  • diabetic history
  • impact on patient’s quality of life.

Information about community management

Further information regarding primary care management of ENT conditions is available on HealthPathways WA (external site). Please email the HealthPathways team to obtain the login details: healthpathways@wapha.org.au. HealthPathways are currently working on responding to the new criteria and will have all the ENT pathways adapted to WA as soon as possible.